The refunds are a part of the extra $214 million given to Blue Cross after a 2020 Supreme Court ruling that insurers were not being compensated by the federal government for risk factors under the ACA during its initial three years. Under the ACA, insurers are required to refund premium income to members if administrative costs and profits are greater than 20 percent of the premiums paid.
Blue Cross first lost money on the health exchange in 2016, claiming the government had placed limits on what it was paid. The insurer doubled its rates over the following two years while withdrawing from Tennessee’s two largest cities in an effort to compensate for the losses, the article said.
The Supreme Court ruled that insurers like Blue Cross were owed higher “risk corridor” payments by CMS.
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